Top

Published in:

Open Access 01-02-2014 | Substantive Review

How Acceptable are Antiretrovirals for the Prevention of Sexually Transmitted HIV?: A Review of Research on the Acceptability of Oral Pre-exposure Prophylaxis and Treatment as Prevention

Authors: Ingrid Young, Lisa McDaid

Published in: AIDS and Behavior | Issue 2/2014

Abstract

Recent research has demonstrated how antiretrovirals (ARVs) could be effective in the prevention of sexually transmitted HIV. We review research on the acceptability of oral pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) for HIV prevention amongst potential users. We consider with whom, where and in what context this research has been conducted, how acceptability has been approached, and what research gaps remain. Findings from 33 studies show a lack of TasP research, PrEP studies which have focused largely on men who have sex with men (MSM) in a US context, and varied measures of acceptability. In order to identify when, where and for whom PrEP and TasP would be most appropriate and effective, research is needed in five areas: acceptability of TasP to people living with HIV; motivation for PrEP use and adherence; current perceptions and management of risk; the impact of broader social and structural factors; and consistent definition and operationalisation of acceptability which moves beyond adherence.

Padian NS, Buve A, Balkus J, Serwadda D, Cates W Jr. Biomedical interventions to prevent HIV infection: evidence, challenges, and way forward. Lancet. 2008;372(9638):585–99.PubMedCrossRef

Sturt Amy S, Dokubo Emily K, Sint Tin T. Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women. Cochrane Database of Systematic Reviews. 2010. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008440/abstract. Accessed 2 Oct 2012.

Rey D. Post-exposure prophylaxis for HIV infection. Expert Rev Anti Infect Ther. 2011;9(4):431–42.PubMedCrossRef

Kippax S, Race K. Sustaining safe practice: twenty years on. Soc Sci Med. 2003;57(1):1–12.PubMedCrossRef

Kippax S, Stephenson N. Beyond the distinction between biomedical and social dimensions of HIV prevention through the lens of a social public health. Am J Public Health. 2012;102(5):789–99.PubMedCrossRef

Havlir D, Beyrer C. The beginning of the end of AIDS? N Engl J Med. 2012;367(8):685–7.PubMedCrossRef

Anderson PL, Glidden DV, Liu A, et al. Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012;4(151):1–8.CrossRef

Okwundu CI, Uthman OA, Okoromah CA. Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals. Cochrane Database Syst Rev. 2012. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007189.pub3/abstract. Accessed 2 Oct 2012.

Food and Drug Administration (FDA). FDA approves first drug for reducing the risk of sexually acquired HIV infection. Silver Spring, MD: FDA. 2012. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm. Accessed 2 Oct 2012.

10.

Center for Disease Control (CDC). Interim guidance: Pre-exposure prophylaxis for the prevention of HIV infection in men who have sex with men. Morbidity and Mortality Weekly Report. 2011;60(3):65–8.

11.

Center for Disease Control (CDC). Interim guidance: pre-exposure prophylaxis for the prevention of HIV infection in heterosexually active adults. Morbidity and Mortality Weekly Report. 2012;61(31):586–9.

12.

Rossi L. Daily HIV prevention approaches didn’t work for African women in the VOICE study. Atlanta: MTN: Microbicides Trials Network. 2013. http://www.mtnstopshiv.org/sites/default/files/attachments/MTN_VOICE_Release_FINAL_.pdf. Accessed 8 May 2013.

13.

ECDC. Thematic report: HIV treatment, care and support: monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and central Asia: 2012 progress report. Stockholm: European Centre for Disease and Prevention Control. 2013.

14.

McCormack S, Fidler S, Fischer M. The British HIV Association/British Association for Sexual Health and HIV position statement on pre-exposure prophylaxis in the UK. Int J STD AIDS. 2012;23(1):1–4.PubMedCrossRef

15.

European Medicines Agency (EMA). Reflection paper on the non-clinical and clinical development for oral and topical HIV pre-exposure prophylaxis (PrEP). London: EMA. 2012. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2012/03/WC500124054.pdf. Accessed 2 Oct 2012.

16.

Cohen MS, McCauley M, Gamble TR. HIV treatment as prevention and HPTN 052. Curr Opin HIV AIDS. 2012;7(2):99–105.PubMedCentralPubMedCrossRef

17.

BHIVA. BHIVA guidelines for the treatment of HIV-1 positive adults with antiretroviral therapy 2012. London: British HIV Association; 2012.

18.

Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents: Department of Health and Human Services, Office of AIDS Research Advisory Council (OARAC).

19.

WHO. 2013. WHO issues new HIV recommendations calling for earlier treatment. World Health Organisation. http://www.who.int/mediacentre/news/releases/2013/new_hiv_recommendations_20130630/en/index.html. Accessed 1 July 2013.

20.

BHIVA, EAGA. Position statement on the use of antiretroviral therapy to reduce HIV transmission January 2013, British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA). HIV Med. 2013;14(5):259–62.CrossRef

21.

Williams BG, Lima V, Gouws E. Modelling the impact of antiretroviral therapy on the epidemic of HIV. Curr HIV Res. 2011;9(6):367–82.PubMedCentralPubMedCrossRef

22.

van de Laar MJ, Pharris A. Treatment as prevention: will it work? Euro Surveillance. 2011;16(48):1–3.

23.

Nguyen VK, Bajos N, Dubois-Arber F, O’Malley J, Pirkle CM. Remedicalizing an epidemic: from HIV treatment as prevention to HIV treatment is prevention. AIDS. 2011;25(3):291–3.PubMedCrossRef

24.

International Collaboration on HIV Optimism. HIV treatments optimism among gay men: an international perspective. J Acquir Immune Defic Syndr. 2003;32(5):545–50.CrossRef

25.

Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292(2):224–36.PubMedCrossRef

26.

Chen Y. Treatment-related optimistic beliefs and risk of HIV transmission: a review of recent findings (2009–2012) in an era of treatment as prevention. Curr HIV/AIDS Rep. 2013;10(1):79–88.PubMedCrossRef

27.

Vernazza PL. The debate continues: does ‘undetectable’ mean ‘uninfectious’? HIV Ther. 2009;3(2):113–6.CrossRef

28.

Rojas Castro D, Fugon L, Bourgeois-Fisson E, Le Gall JM, Barbier F, Spire B. The “Swiss Statement”: Who knows about it? How do they know? What are its effects on people living with HIV/AIDS? AIDS Care. 2012;24(8):1013–9.PubMedCrossRef

29.

Persson A. Reflections on the Swiss Consensus Statement in the context of qualitative interviews with heterosexuals living with HIV. AIDS Care. 2010;22(12):1487–92.PubMedCrossRef

30.

de Wit JBF, Aggleton P, Myers T, Crewe M. The rapidly changing paradigm of HIV prevention: time to strengthen social and behavioural approaches. Health Educ Res. 2011;26(3):381–92.PubMedCrossRef

31.

Diallo DD. 2013. Coalition of U.S. Women’s health and HIV advocates call for accelerated us government plan for demonstrating feasibility of PrEP for women. Working Group on U.S. Women and PrEP. http://www.avac.org/ht/a/GetDocumentAction/i/49158. Accessed 1 July 2013.

32.

Amico KR. Adherence to pre-exposure chemoprophylaxis: the behavioral bridge from efficacy to effectiveness. Curr Opin HIV AIDS. 2012;7(6):542–8.PubMedCrossRef

33.

Golub SA, Operario D, Gorbach PM. Pre-exposure prophylaxis state of the science: empirical analogies for research and implementation. Curr HIV/AIDS Rep. 2010;7(4):201–9.PubMedCentralPubMedCrossRef

34.

Severy LJ, Newcomer S. Critical issues in contraceptive and STI acceptability research. J Soc Issues. 2005;61(1):45–65.CrossRef

35.

Mensch BS, van der Straten A, Katzen LL. Acceptability in microbicide and PrEP trials: current status and a reconceptualization. Curr Opin HIV AIDS. 2012;7(6):534–41.PubMedCrossRef

36.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296.CrossRef

37.

Guest G, Shattuck D, Johnson L, et al. Changes in sexual risk behavior among participants in a PrEP HIV prevention trial. Sex Transm Infect. 2008;35(12):1002–8.

38.

Guest G, Shattuck D, Johnson L, et al. Acceptability of PrEP for HIV prevention among women at high risk for HIV. J Womens Health. 2010;19(4):791–8.CrossRef

39.

Ware NC, Wyatt MA, Haberer JE, et al. What’s love got to do with it? Explaining adherence to oral antiretroviral pre-exposure prophylaxis for HIV-serodiscordant couples. J Acquir Immune Defic Syndr. 2012;59(5):463–8.PubMedCrossRef

40.

Minnis AM, Gandham S, Richardson BA, et al. Adherence and acceptability in MTN 001: a randomized cross-over trial of daily oral and topical tenofovir for HIV prevention in women. AIDS Behav. 2013;17(2):737–47.PubMedCrossRef

41.

Mutua G, Sanders E, Mugo P, et al. Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers. PLoS One. 2012;7(4):e33103.PubMedCentralPubMedCrossRef

42.

Van der Elst EM, Mbogua J, Operario D, et al. High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at-risk populations in Kenya. AIDS Behav. 2013;17(6):2162–72.PubMedCentralPubMedCrossRef

43.

Hosek S, Siberry G, Bell M, et al. The acceptability and feasibility of an HIV pre-exposure prophylaxis (PrEP) trial with young men who have sex with men (YMSM). J Acquir Immune Defic Syndr. 2012;62(4):447–56.

44.

Amico KR, McMahan V, Goicochea P, et al. Supporting study product use and accuracy in self-report in the iPrEx study: next step counseling and neutral assessment. AIDS and Behavior. 2012;16(5):1243–59.CrossRef

45.

Barash EA, Golden M. Awareness and use of HIV pre-exposure prophylaxis among attendees of a Seattle gay pride event and sexually transmitted disease clinic. AIDS Patient Care STDs. 2010;24(11):689–91.PubMedCrossRef

46.

Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee SJ, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011;23(9):1136–45.PubMedCentralPubMedCrossRef

47.

Brooks RA, Landovitz RJ, Kaplan RL, Lieber E, Lee SJ, Barkley TW. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study. AIDS Patient Care STDs. 2012;26(2):87–94.PubMedCrossRef

48.

Golub SA, Kowalczyk W, Weinberger CL, Parsons JT. Pre-exposure prophylaxis and predicted condom use among high-risk men who have sex with men. J AIDS. 2010;54(5):548–55.

49.

Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS One. 2012;7(3):e33119.PubMedCentralPubMedCrossRef

50.

Mansergh G, Koblin BA, Colfax GN, McKirnan DJ, Flores SA, Hudson SM. Preefficacy use and sharing of antiretroviral medications to prevent sexually-transmitted HIV infection among us men who have sex with men. J AIDS. 2010;55(2):e14–6.

51.

Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Pre-exposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009;50(1):77–83.PubMedCentralPubMedCrossRef

52.

Nodin N, Carballo-Dieguez A, Ventuneac AM, Balan IC, Remien R. Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback. AIDS Care. 2008;20(1):106–15.PubMedCrossRef

53.

Galindo GR, Walker JJ, Hazelton P, et al. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation. Implement Sci. 2012;7(1):116.PubMedCentralPubMedCrossRef

54.

Saberi P, Gamarel KE, Neilands TB, et al. Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in San Francisco: a mixed methods study. PLoS One. 2012;7(11):e50061.PubMedCentralPubMedCrossRef

55.

Aghaizu A, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. Who would use PrEP? Factors associated with intention to use among MSM in London: a community survey. Sex Transm Infect. 2013;89(3):207–11.PubMedCrossRef

56.

Leonardi M, Lee E, Tan DH. Awareness of, usage of and willingness to use HIV pre-exposure prophylaxis among men in downtown Toronto, Canada. Int J STD AIDS. 2011;22(12):738–41.PubMedCrossRef

57.

Lorente N, Fugon L, Carrieri MP, et al. Acceptability of an “on-demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France. AIDS Care. 2012;24(24):468–77.PubMed

58.

Holt M, Murphy DA, Callander D, et al. Willingness to use HIV pre-exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected anal intercourse and the perceived likelihood of becoming HIV positive among Australian gay and bisexual men. Sex Transm Infect. 2012;88(4):258–63.PubMedCrossRef

59.

Poynten IM, Jin F, Prestage GP, Kaldor JM, Imrie J, Grulich AE. Attitudes towards new HIV biomedical prevention technologies among a cohort of HIV-negative gay men in Sydney, Australia. HIV Med. 2010;11(4):282–8.PubMedCrossRef

60.

van Griensven F, Thienkrua W, Sukwicha W, et al. Sex frequency and sex planning among men who have sex with men in Bangkok, Thailand: implications for pre- and post-exposure prophylaxis against HIV infection. J Int AIDS Soc. 2010;13(13):1–14.

61.

Jackson T, Huang A, Chen H, Gao X, Zhong X, Zhang Y. Cognitive, psychosocial, and sociodemographic predictors of willingness to use HIV pre-exposure prophylaxis among Chinese men who have sex with men. AIDS Behav. 2012;16(7):1853–61.PubMedCrossRef

62.

Zhou F, Gao L, Li S, et al. Willingness to accept HIV pre-exposure prophylaxis among Chinese men who have sex with men. PLoS One. 2012;7(3):e32329.PubMedCentralPubMedCrossRef

63.

Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: Barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62.PubMedCentralPubMedCrossRef

64.

Eisingerich AB, Wheelock A, Gomez GB, Garnett GP, Dybul MR, Piot PK. Attitudes and acceptance of oral and parenteral HIV preexposure prophylaxis among potential user groups: a multinational study. PLoS One. 2012;7(1):e28238.PubMedCentralPubMedCrossRef

65.

Whiteside YO, Harris T, Scanlon C, Clarkson S, Duffus W. Self-perceived risk of HIV infection and attitudes about pre-exposure prophylaxis among sexually transmitted disease clinic attendees in South Carolina. AIDS Patient Care STDs. 2011;25(6):365–70.PubMedCrossRef

66.

Smith DK, Toledo L, Smith DJ, Adams MA, Rothenberg R. Attitudes and program preferences of African–American urban young adults about pre-exposure prophylaxis (PrEP). AIDS Educ Prev. 2012;24(5):408–21.PubMedCrossRef

67.

Dombrowski JC, Harrington RD, Fleming M, Golden MR. Treatment as prevention: are HIV clinic patients interested in starting antiretroviral therapy to decrease HIV transmission? AIDS Patient Care STDs. 2010;24(12):747–50.PubMedCrossRef

68.

Kalichman SC, Eaton L, Cherry C. Sexually transmitted infections and infectiousness beliefs among people living with HIV/AIDS: implications for HIV treatment as prevention. HIV Med. 2010;11(8):502–9.PubMedCentralPubMed

69.

Holt M, Murphy D, Callander D, et al. HIV-negative and HIV-positive gay men’s attitudes to medicines, HIV treatments and antiretroviral-based prevention. AIDS Behav. 2012;17(6):2156–61.CrossRef

70.

Amico K, McMahan V, Goicochea P, et al. Supporting study product use and accuracy in self-report in the iPrEx study: next step counseling and neutral assessment. AIDS Behav. 2012;16(5):1243–59.CrossRef

71.

Puro V, Palummieri A, de Carli G, Piselli P, Ippolito G. Attitudes towards antiretroviral pre-exposure prophylaxis (PrEP) prescription among HIV specialists. BMC Infect Dis. 2013;13(217):1–8.

72.

Mascolini M. Tenofovir PrEP reduces HIV transmission risk by up to 99%: adherence critical to protection from HIV in partners PrEP trial of TDF and TDF/FTC 19th Conference on Retroviruses and Opportunistic Infections. Washington: Seattle; 2012.

73.

Bourne A, Dodds C, Weatherburn P, et al. Plus one: HIV sero-discordant relationships among black African people in England. London: Sigma Research; 2011.

74.

Roberts ET, Matthews DD. HIV and chemoprophylaxis, the importance of considering social structures alongside biomedical and behavioral intervention. Soc Sci Med. 2012;75(9):1555–61.PubMedCrossRef

Title: How Acceptable are Antiretrovirals for the Prevention of Sexually Transmitted HIV?: A Review of Research on the Acceptability of Oral Pre-exposure Prophylaxis and Treatment as Prevention
Authors: Ingrid Young
Lisa McDaid
Publication date: 01-02-2014
Publisher: Springer US
Published in: AIDS and Behavior / Issue 2/2014
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-013-0560-7

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

How Acceptable are Antiretrovirals for the Prevention of Sexually Transmitted HIV?: A Review of Research on the Acceptability of Oral Pre-exposure Prophylaxis and Treatment as Prevention

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2014

Acceptability, Knowledge, Beliefs, and Partners as Determinants of Zambian Men’s Readiness to Undergo Medical Male Circumcision

The Impact of a National Poverty Reduction Program on the Characteristics of Sex Partners Among Kenyan Adolescents

Factors Associated with a Willingness to Accept Rapid HIV Testing in an Urban Emergency Department

Relationships Between Dimensions of Disability Experienced by Adults Living with HIV: A Structural Equation Model Analysis

Structural Bridging Network Position is Associated with HIV Status in a Younger Black Men Who Have Sex with Men Epidemic

Geographical Clustering of High Risk Sexual Behaviors in “Hot-Spots” for HIV and Sexually Transmitted Infections in Kwazulu-Natal, South Africa

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page